Journal of Korean Medicine Rehabilitation (한방재활의학과학회지)

The society of Korean Medicine Rehabilitation (한방재활의학과학회)
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The Effect of Korean Medicinal Admission Treatment and Radiological Characteristics on 25 Cases of Spondylolysis

척추분리증 환자 25예의 한방 입원치료 효과와 영상의학적 특성

  • Lee, Sang-Won (Department of Rehabilitation Medicine of Korean Medicine, Mokhuri Neck and Back Hospital) ;
  • Kim, Yang-Sun (Department of Rehabilitation Medicine of Korean Medicine, Mokhuri Neck and Back Hospital) ;
  • Kim, Yong-Wha (Department of Acupuncture and Moxibustion Medicine, Mokhuri Neck and Back Hospital) ;
  • Kim, Yu-Gon (Department of Rehabilitation Medicine of Korean Medicine, Mokhuri Neck and Back Hospital) ;
  • Park, Han-Sol (Department of Science in Korean Medicine, Graduate School, Kyung Hee University) ;
  • Lee, Ji-Eun (Department of Korean Medicine Rehabilitation, College of Korean Medicine, Dongshin University) ;
  • Lim, Jin-Woong (Department of Acupuncture and Moxibustion Medicine, Mokhuri Neck and Back Hospital) ;
  • Jeong, Hyeon-Gyo (Department of Rehabilitation Medicine of Korean Medicine, Mokhuri Neck and Back Hospital) ;
  • Choi, In-Seok (Department of Rehabilitation Medicine of Korean Medicine, Mokhuri Neck and Back Hospital)
  • 이상원 (모커리한방병원 한방재활의학과) ;
  • 김양선 (모커리한방병원 한방재활의학과) ;
  • 김용화 (모커리한방병원 침구의학과) ;
  • 김유곤 (모커리한방병원 한방재활의학과) ;
  • 박한솔 (경희대학교 대학원 기초한의과학과교실) ;
  • 이지은 (동신대학교 한의과대학 한방재활의학과교실) ;
  • 임진웅 (모커리한방병원 침구의학과) ;
  • 정현교 (모커리한방병원 한방재활의학과) ;
  • 최인석 (모커리한방병원 한방재활의학과)
  • Received : 2019.11.12
  • Accepted : 2019.11.19
  • Published : 2020.01.31
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Abstract

Objectives The purpose of this study is to assess the effect of korean medicinal admission treatment for degenerative lumbar diseases with spondylolysis and analyze their radiological findings. Methods This study was performed on 25 cases' medical records of spondylolysis patients with both X-rays and MRI images. Their general characteristics, morphologies of intervertebral discs, grades of spondylolisthesis, grades of intervertebral foraminal stenosis were analyzed. The efficacy of treatment was evaluated by numeric pain rating scale (NPRS) changes and statistically assessed by paired t-test using program R Studio. Results After admission treatment, NPRS scores significantly decreased from 6.76±2.07 to 2.38±1.22 (p<0.01). Spondylolysis was associated with degenerative disc change and intervertebral foraminal stenosis at the same or adjacent vertebral level. In spondylolisthesis cases (76%), forward slippage occurred at the same level of spondylolysis in every case. Conclusions Spondylolysis could play a key role in the lumbar degenerative mechanism and korean medicinal admission treatment is effective on pain relief of degenerative lumbar diseases with spondylolysis.

Keywords

References

  1. Rauch RA, Jinkins JR. Lumbosacral spondylolisthesis associated with spondylolysis. Neuroimaging Clin N Am. 1993;3:543-55.
  2. Ward CV, Latimer B, Alander DH, Parker J, Ronan JA, Holden AD, Sanders C. Radiographic assessment of lumbar facet distance spacing and spondylolysis. Spine. 2007;32:85-8.
  3. Brooks BK, Southam S, Mlady GW, Logan J, Rosett M. Lumbar spine spondylolysis in the adult population: using computed tomography to evaluate the possibility of adult onset lumbar spondylosis as a cause of back pain. Skeletal Radiol. 2010;39(7): 669-73. https://doi.org/10.1007/s00256-009-0825-4
  4. Teplick JG, Lafley PA, Berman A, Haskin ME. Diagnosis and evaluation of spondylolisthesis and/or spondylolysis on axial CT. AJNR Am J Neuroradiol. 1986;7:479-91.
  5. Floman Y. Progression of lumbosacral isthmic spondylolisthesis in adults. Spine. 2000;25:342-7. https://doi.org/10.1097/00007632-200002010-00014
  6. Szypryt EP, Twining P, Mulholland RC, Worthington BS. The prevalence of disc degeneration associated with neural arch defects of the lumbar spine assessed by magnetic resonance imaging. Spine. 1989;14(9):977-81. https://doi.org/10.1097/00007632-198909000-00011
  7. Ulmer JL, Mathews VP, Elster AD, Mark LP, Daniels DL, Mueller W. MR imaging of lumbar spondylolysis: the importance of ancillary observations. AJR Am J Roentgenol. 1997;169:233-9. https://doi.org/10.2214/ajr.169.1.9207531
  8. Grenier N, Kressel HY, Schiebler ML, Grossman RI. Isthmic spondylolysis of the lumbar spine: MR imaging at 1.5 T. Radiology. 1989;170:489-93. https://doi.org/10.1148/radiology.170.2.2911673
  9. Major NM, Helms CA, Richardson WJ. MR imaging of fibrocartilaginous masses arising on the margins of spondylolysis defects. AJR Am J Roentgenol. 1999;173:673-6. https://doi.org/10.2214/ajr.173.3.10470901
  10. Iwamoto J, Takeda T, Wakano K. Returning athletes with severe low back pain and spondylolysis to orginal sporting activities with conservative treatment. Scand J Med Sci Sports. 2004;14(6):346-51. https://doi.org/10.1111/j.1600-0838.2004.00379.x
  11. Kim SJ, Yoon JP, Kim SY. A clinical analysis of 40 cases with spondylolisthesis. J Oriental Rehab Med. 2002;12(3):1-10.
  12. Park SM, Hwang DG, Kim EJ, Kim JY, Jung SY. A case report of spondylolytic spondylolisthesis treated with an oriental medical treatment. J Int Korean Med. 2016;37(5):685-90. https://doi.org/10.22246/jikm.2016.37.5.685
  13. Childs JD, Piva SR, Fritz JM. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine. 2005;30(11):1331-4. https://doi.org/10.1097/01.brs.0000164099.92112.29
  14. Tulder M, Becker A, Bekkering T, Breen A, Carter T, Teresa M, Hutchinson A, Koes B, Kryger P, Laerum E, Malmivaara A, Nachemson A, Niehus W, Roux E, Rozenberg S. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J. 2006;15:169-91.
  15. Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Rothman SLG, Sze G. Lumbar disc nomenclature: Version 2.0. Spine. 2014;39(24);1448-65.
  16. Kunogi J, Haseu M. Diagnosis and operative treatment of intraforaminal and extraforaminal nerve root compression. Spine. 1991;16;1312-20. https://doi.org/10.1097/00007632-199111000-00012
  17. Davidson M, Keating J. Oswestry disability questionnaire (ODQ). Australian Journal of Physiotherapy. 2005;51(4):270. https://doi.org/10.1016/s0004-9514(05)70016-7
  18. Leone A, Cianfoni A, Cerase A, Magarelli N, Bonomo L. Lumbar spondylolysis: a review. Skeletal Radiol. 2011;40:683-700. https://doi.org/10.1007/s00256-010-0942-0
  19. Leone A, Guglielmi G, Cassar-Pullicino VN, Bonomo L. Lumbar intervertebral instability: a review. Radiology. 2007;245:62-77. https://doi.org/10.1148/radiol.2451051359
  20. Mihara H, Onari K, Cheng BC, David SM, Zdeblick TA. The biomechanical effect of spondylolysis and its treatment. Spine. 2003;28:235-8. https://doi.org/10.1097/01.BRS.0000042226.59713.0E
  21. Vialle R, Ilharreborde B, Danzac C, Lenoir T, Rillardon L, Guigui P. Is there a sagittal imbalance of the spine in isthmic spondylolisthesis? A correlationstudy. Eur Spine J. 2007;16:1641-9. https://doi.org/10.1007/s00586-007-0348-4